Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live in a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Position Summary:
Primarily focused on mapping data from one system to another, role function involves run in data activities associated with the running, planning and organization of the data as well as supporting data run-in and integration services to ensure efficient and effective business operations while establishing and enforcing standards and procedures. Key Responsibilities:
- Downloading, tracking, reviewing and documenting healthcare data.
- Normalizing and converting data from one medium to another.
- Interacts with other internal team members to trouble shoot and resolve underlying problems.
- Comprehensive review of completed data reports in order to identify errors.
- Contribute to support knowledge base by creating or updating solution documents.
- Working with stakeholders to develop implementation plans, analyzing field mapping, coordinating with 3rd party conversion partners, and auditing for errors and necessary corrections.
- Ensuring accuracy of data and operational standards are met, reviewing/documenting procedures for accuracy and operational efficiency-recommending changes as required, and analyzing system problems as needed-making recommendations to ensure against reoccurrence.
- Will support on key projects and may lead smaller projects of moderate complexity.
- Serves as senior subject matter expert associated with content, processes, and procedures.
- Bachelor's degree or 5 years related experience required.
- Previous medical claim processing experience
- CPT and HCPCS knowledge
- DOFR knowledge
- Microsoft Excel skills
U.S. Eligibility Requirements:
- Ideal candidate has worked as a medical claim auditor
- Knowledge of reinsurance and/or catastrophic claims
- Microsoft Access and SQL skills
- Interested candidates must submit an application and resume/CV online to be considered
- Must be 18 years of age or older or must demonstrate legal capacity to enter a contract
- Must be willing to submit to a background investigation; any offer of employment is conditioned upon the successful completion of a background investigation
- Must have unrestricted work authorization to work in the United States. For U.S. employment opportunities, Gallagher hires U.S. citizens, permanent residents, asylees, refugees, and temporary residents. Temporary residence does not include those with non-immigrant work authorization (F, J, H or L visas), such as students in practical training status. Exceptions to these requirements will be determined based on shortage of qualified candidates with a particular skill. Gallagher will require proof of work authorization
- Must be willing to execute Gallagher's Employee Agreement or Confidentiality and Non-Disclosure Agreement, which require, among other things, post-employment obligations relating to non-solicitation, confidentiality and non-disclosure
- Gallagher offers competitive salaries and benefits, including: medical/dental/vision plans, life and accident insurance, 401(K), employee stock purchase plan, educational expense reimbursement, employee assistance program, flexible work hours (availability varies by office and job function) training programs, matching gift program, and more.
Gallagher believes that all persons are entitled to equal employment opportunity and does not discriminate against nor favor any applicant because of race, sex, color, disability, national origin, religion, creed, age, marital status, citizenship, veteran status, gender, gender identity / expression, actual or perceived sexual orientation, or any other protected characteristic. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified applicant with a disability, unless the accommodation would impose an undue hardship on the operation of our business.